Reinvestigation of the N-terminal amino acid sequence of beta-lipotropin from human pituitary glands.
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Amino Acid Sequence↗
Biomedical subjects
C L Lu
Publications and source records attributed to C L Lu.
Membranous obstruction of inferior vena cava in Taiwan.
Membranous obstruction of the inferior vena cava (MOVC) is a rare cause of Budd-Chiari syndrome. When compared to the West, the incidence of MOVC was reported to be higher in the Orient, India and South Africa. From 1979 to 1993, 16 consecutive Chinese patients (mean age 50 years) with MOVC were retrospectively evaluated. The diagnosis in these MOVC patients was usually delayed with a mean lag time of 111 months. Most of the cases were detected by a delicate ultrasonographic examination of the abdomen. Segmental narrowing of the inferior vena cava in 11 patients was the predominant type of MOVC, while five experienced a membranous obstructive type. Only one of five surgery-treated patients had a post-operation survival > 5 years, while five out of the nine patients who received conservative treatment still survived after a 6-15 year follow up. Two patients received percutaneous angioplasty (PTA). One survived 4 years and the other expired 5 years after the PTA. Two patients (12%) developed a hepatocellular carcinoma in their disease course, and the incidence was lower than in previous reports from Japan and South Africa. The incidence of hepatitis B surface antigen in MOVC did not increase in our patients compared with the general population. In conclusion, the inferior vena cava should be carefully evaluated in an ultrasonographic examination of the abdomen to increase the diagnosis rate of MOVC. Surgical intervention should be carefully justified according to the patient's symptoms and signs, the types of obstructive lesions and the expertise of the surgeons.
Adult↗
Budd-Chiari syndrome due to pacemaker-induced thrombosis.
We report a unique case of Budd-Chiari syndrome caused by pacemaker leads-induced thrombosis. A 34 year old female patient was subjected to a permanent pacemaker insertion because of refractory paroxysmal supraventricular tachycardia attacks related to Wolff-Parkinson-White syndrome. Three years later, another pacemaker was re-implanted because of its dislodgement. Four episodes of skin infections at the implantation site were noted thereafter. The patient developed symptoms of abdominal pain and ascites 5 years after the second pacemaker implantation. Ultrasonography and computerized tomography of the abdomen revealed hepatomegaly with ascites and dilated inferior vena cava. An echocardiogram displayed thrombus formation in the superior vena cava, the right atrium and the inlet of the inferior vena cava into the right atrium. Inferior and superior venacavogram confirmed the above findings. With the impression that Budd-Chiari syndrome was caused by pacemaker-induced thrombus, we removed the pacemaker first and thoracotomy with thrombectomy was then performed. The clinical symptoms resolved after the operation. To our knowledge, this is the first case reported in the literature and this observation supported the thrombosis theory for membranous obstruction of inferior vena cava.
Abdomen↗
Efficacy of ursodeoxycholic acid in the treatment of patients with chronic hepatitis C.
A case-control study was conducted to evaluate the efficacy of ursodeoxycholic acid (UDCA) in the treatment of Chinese patients with chronic hepatitis C. Patients who failed to have sustained responses to interferon (IFN) therapy, refused to take IFN or were unsuitable for IFN treatment were enrolled into this study. The treatment group had 15 patients and they received UDCA 600 mg orally per day for 6 months. Another 15 patients with matched sex, age and initial serum alanine aminotransferase (ALT) levels were chosen as the control group. Three parameters (i.e. serum ALT levels, serum hepatitis C virus (HCV) RNA and serum cytokines) were measured before and after UDCA treatment. After the treatment period, the mean serum ALT levels in both groups were not significantly different (153.8 +/- 111.0 U/L vs 112.1 +/- 53.8 U/L, P > 0.05) and mean serum ALT level in the UDCA-treated group did not decrease after the treatment (pre-treatment vs post-treatment value: 139.1 +/- 73.1 U/L vs 153.8 +/- 111.0 U/L, P > 0.05). In addition, all of the patients with positive HCV RNA before treatment still had active HCV viraemia after the UDCA treatment. Also, the serum levels of interleukin-6 (IL-6) and the tumour necrosis factor-alpha (TNF-alpha) were not significantly different between the two groups before and after the treatment period. In conclusion, a regimen of UDCA as prescribed in the present study did not show obvious benefits in the treatment of Chinese patients with chronic hepatitis C.
Alanine Transaminase↗
Interleukin-2 and its effects in the central nervous system.
Interleukin-2 (IL-2) is not only an important immunoregulatory molecule: it is also an important neuroregulatory molecule in the CNS. Investigations in vivo and in vitro have elucidated the following: IL-2 and IL-2 receptors (IL-2R) have been detected in the brain; IL-2 promotes survival and neurite extension of cultured neurons, stimulates oligodendrocyte proliferation and maturation, affects the hypothalamic-pituitary function and produces behavioral and electrocorticogram spectrum changes. Investigations in some laboratories, including ours, have also demonstrated an analgesic effect of IL-2 in the CNS. The molecular structure of the analgesic domain of IL-2 is distinct from the immune domain mediating immunoregulatory effects. A possible mechanism of action of cytokines on the CNS and the immune system or both exists: multiple actions of cytokines could be mediated by distinct domains or functional sites of cytokines interacting with different receptors or receptor subtypes.
Analgesics, Non-Narcotic↗
The risk factors for gallstone disease among senior citizens: an Oriental study.
BACKGROUND/AIMS: Few Occidental studies have addressed the risk factors for gallstone disease (GSD), among aged people. It is unknown whether these factors also present in the Orientals. Therefore, we studied the prevalence and risk factors for GSD among aged people in Taiwan. METHODOLOGY: 1441 aged subjects (> or = 60 years) who received a paid physical checkup at this hospital were investigated. Their demographic characteristics and biochemical parameters were recorded and compared. Ultrasonographic diagnosis revealed a normal gallbladder in 1092 subjects, gallbladder stones in 171, cholecystectomy for gallstones in 65, gallbladder polyps in 83, mixed gallbladder stones/polyps in 10, and miscellaneous results in 20. We enrolled 236 subjects showing either gallbladder stones or cholecystectomy for gallstones as the GSD group. RESULTS: Excluding those subjects with mixed gallbladder stones/polyps, the overall prevalence of GSD in our series was 16.6%. Using multivariate analysis, the encountered factors manifesting risk for the development of GSD were old age (p<0.001), lower serum high-density lipoprotein level (p<0.01), diabetes mellitus (adjusted odds ratio: 2.127; p<0.001) and glucose intolerance (adjusted odds ratio: 1.954; p<0.001), whereas past history of alcohol consumption (adjusted odds ratio: 0.335; p<0.01) exhibited a protective effect against the development of GSD. Other demographic characteristics and biochemical parameters, such as body mass index, ABO blood type, cigarette smoking, blood pressure, serum cholesterol level, hepatitis B virus carrier, liver function, and parity, did not have any correlation to GSD. CONCLUSIONS: Among the aged senior citizens in Taiwan, individuals with old age, lower serum high-density lipoprotein level, diabetes and glucose intolerance are at high risk for developing GSD.
Aged↗
Gastric inhibitory polypeptide appears less important in mediating acid secretion.
BACKGROUND/AIMS: Gastric inhibitory polypeptide is recognized as an acid inhibitor, while its relationship with Helicobacter pylori colonization is unknown. The present study measured serum gastric inhibitory polypeptide levels in patients after various types of gastric resection and the influence of demographic characteristics including Helicobacter pylori on serum gastric inhibitory polypeptide levels. METHODOLOGY: The study included twenty patients who underwent distal gastrectomy for duodenal ulcer, 33 patients who underwent radical subtotal gastrectomy for gastric carcinoma and 7 patients who underwent total gastrectomy. Another 58 healthy subjects served as controls. Their demographic characteristics were recorded, while serum gastric inhibitory polypeptide levels were measured using a homemade radioimmunoassay kit. RESULTS: The serum gastric inhibitory polypeptide levels in the three patient groups and the controls were 246.2+/-38.7 pg/ml, 201.7+/-30.9 pg/ml, 183.5+/-34.5 pg/ml and 202.6+/-14.0 pg/ml, respectively. The difference among the four groups was not significant. Neither age, gender, body mass index, smoking, Helicobacter pylori colonization nor type of gastrectomy had an influence on serum gastric inhibitory polypeptide levels in the controls and the three patient groups. However, elapsed time since operation in patients following total gastrectomy exhibited a significant positive correlation with their gastric inhibitory polypeptide levels (r=0.89, p<0.05). CONCLUSIONS: Serum gastric inhibitory polypeptide levels remain unchanged in patients undergoing various types of gastrectomy. Colonization of Helicobacter pylori does not influence its level. This peptide is probably less important in mediating gastric acid secretion.
Aged↗
The experience of endoscopic tissue glue injection in the treatment of hepatic sarcoidosis related gastric variceal bleeding: report of a case.
A case of hepatic sarcoidosis complicated with portal hypertension and gastric variceal bleeding is described. A 53 year-old male suffered from persistent fever and massive hematemesis. Acute gastric variceal bleeding was diagnosed. Endoscopic tissue glue injection stopped this acute episode and ablated the varices after another two sessions of endoscopic tissue glue injection treatment. Subsequent administration of corticosteroids improved the symptoms and liver function. This was probably the first case of hepatic sarcoidosis associated with gastric variceal bleeding which was successfully treated by endoscopic tissue glue injection to be reported.
Acute Disease↗
Preserved esophagogastric manometric motility in patients after distal gastrectomy.
BACKGROUND/AIMS: A prospective study resolved whether commonly employed distal gastrectomies could influence the esophagogastric manometric measurements and the role of vasoactive intestinal polypeptide in mediating motility after surgery. METHODOLOGY: Studied groups consisted of 20 patients following radical subtotal gastrectomy for gastric cancer, 20 patients after subtotal gastrectomy for duodenal ulcer and 20 controls. Fasting blood was obtained to measure serum vasoactive intestinal polypeptide levels. A pneumohydraulic infusion system measured esophagogastric motility parameters. RESULTS: Measured lower esophageal sphincter pressures in subjects of gastric cancer surgery, duodenal ulcer surgery and controls were 15.3 +/- 4.7, 13.1 +/- 5.3 and 12.6 +/- 5.0 mmHg, respectively (NS), while the sphincter lengths were 3.15 +/- 0.81, 3.22 +/- 0.79 and 2.86 +/- 0.85 cm, respectively (NS). In addition, other parameters including lower esophageal body remained unchanged. The serum vasoactive intestinal polypeptide levels of three groups were 24.1 +/- 10.8, 22.5 +/- 9.5 and 21.3 +/- 7.8 pg/ml, respectively (NS). CONCLUSIONS: Neither gastric cancer nor duodenal ulcer in distal stomach removal can alter the lower esophageal body and LES manometric motilities. Unchanged serum VIP levels after gastric surgery are likely one of the mechanisms preserving esophagogastric integrity.
Aged↗
Abdominal aortic aneurysm compression is probably responsible for the recurrent episodes of acute pancreatitis: case report.
An aged male with a known history of abdominal aortic aneurysm suffered from epigastralgia, vomiting and cold sweating for one day. According to the physical examination, serum amylase level and computed tomographic examination, acute pancreatitis was diagnosed. Surgical intervention for the abdominal aortic aneurysm was not performed because of his age, and finally this patient died after three recurrent episodes. Acute pancreatitis co-existing with an intact abdominal aortic aneurysm has never been reported before. The possible pathogenesis of this recurrent acute pancreatitis was discussed.
Acute Disease↗
Duodenal lesions following severe acute pancreatitis: review of 10 years' clinical experience.
BACKGROUND/AIMS: Acute pancreatitis may result in many local and contiguous organ complications; though the pancreas is in close proximity to the duodenum anatomically, acute pancreatitis causing duodenal lesions is rarely encountered. Our aim is to retrospectively evaluate the clinical features of the duodenal lesions in patients with severe acute pancreatitis. METHODOLOGY: During the past 10 years, 1,637 consecutive patients with acute pancreatitis were admitted to Taipei Veterans General Hospital. Total parenteral nutrition was employed in 251 patients with acute pancreatitis, defined as 'severe acute pancreatitis'. They had all received computed tomography during the hospitalization period, and the computed tomography reports were reviewed to find patients with duodenal involvement induced from pancreatitis. We defined those patients having duodenal wall thickening, extrinsic compression of the duodenum, or other obstructive lesions seen on the computed tomography scan as evident duodenal lesion or duodenal involvement. RESULTS: Nine cases of evident duodenal lesions following severe acute pancreatitis have been documented over a 10-year period in 1 teaching medical center. The lesions were found by image study or during operation. The most frequently involved site was the second portion of the duodenum. Clinically, 1 unique case developed severe duodenal obstruction requiring surgical correction, and 7 cases recovered after supportive therapy. Of the 9, only 1 case died of multiple organ failure. CONCLUSIONS: In contrast to the colonic lesions caused by acute pancreatitis with a high morbidity and mortality, total parenteral nutrition yields a good prognosis in patients with evident duodenal lesions following severe acute pancreatitis.
Adult↗
Dynamic internal compliance of a vascular prosthesis.
A new technique was used to measure dynamic internal compliance of a blood vessel or vascular graft subjected to dynamic internal pressure. The internal compliance can be broken into three categories: the volumetric compliance (CV), defined as (dV/V)/dP; the longitudinal compliance (CL), defined as (dL/L)/dP; and radial compliance (CR), defined as (dR/R)/dP. It can be shown mathematically that CV = 2 CR + CL. Thus, measuring any two of the three entities will also give the value for the third. A Dynatek DCT1 dynamic compliance tester was used for measuring the compliance of DenaflexTM biologic grafts and fresh bovine internal thoracic arteries, from which the Denaflex grafts were obtained by fixation. Volumetric compliance was obtained with the test sample mounted in a loose loop that allowed the sample to move both radially and longitudinally. By mounting the sample in a straight fashion that limited longitudinal movement, the radial compliance was determined. The longitudinal compliance was then calculated from the above relationship. Test results show that the fresh bovine artery had an average volumetric compliance of 26.1%/100 mmHg, radial compliance of 9.5%/100 mmHg, and longitudinal compliance of 7.2%/100 mmHg. The Denaflex vascular graft showed a reduction in longitudinal and radial compliance, compared to the fresh raw artery, as a result of extensive fixation.
Animals↗
Performance of a longitudinally compliant PTFE vascular prosthesis in an ovine A-V fistula model.
Nine chronic implants of 6 mm diameter vascular grafts were performed in an ovine model to compare the performance of the longitudinally compliant Ultraflex PTFE-Plus vascular prosthesis with that of the Gore-Tex reinforced expanded polytetra fluoroethylene (PTFE) graft. Implants were performed in the sheep neck as right carotid to left jugular arterio-venous (A-V) grafts. Grafts were explanted after 6 months unless they occluded earlier. The Ultraflex graft demonstrated superior handling characteristics during implant. Patency rate at 6 months was 60% (three of five) for the Ultraflex graft (experimental graft by Baxter Edwards, CVS Division, Irvine, CA), and 25% (one of four) for the Gore-Tex graft (WL Gore & Associates, Inc., Flagstaff, AZ). The Gore-Tex prosthesis had more calcification of the graft wall.
Animals↗